Head and neck squamous cell carcinoma in patients aged > or = 80 years: patterns of care and survival

Background: Scarce data exist concerning the outcome of very elderly patients with head and neck squamous cell carcinoma (HNSCC).

Methods: The clinical files of 316 patients aged > or = 80 years with HNSCC who were included in the authors' hospital database between 1987 and 2006 were reviewed retrospectively.

Results: Approximately 88% of patients received locoregional treatment, 31% of patients underwent surgery, and 57% of patients received definitive radiotherapy. The median disease-specific survival (DSS) was 21.3 months, and a plateau was observed after 5 years. The median overall survival (OS) was 13.0 months. Both the median DSS and the median OS were longer for patients with stage I/II HNSCC than for patients with stage III/IV HNSCC (median DSS, not reached vs 11.4 months; P < .001; median OS, 41.9 months vs 7.9 months; P < .001). On multivariate analysis, stage I/II disease, treatment with curative intent, and evidence of locoregional control were independent predictors of improved survival.

Conclusions: The outcome of patients with stage I/II HNSCC aged > or = 80 years was similar to that of younger patients, and the current results indicated that age should not be used to deny them optimal treatment. Elderly patients with stage III/IV HNSCC had poor survival. Geriatric tools should be used to identify elderly patients who are eligible for optimal locoregional treatment.